Skip to Primary Navigation Skip to Site Navigation Skip to Main Content All 3M.com Site Map
3M<sup>™</sup> Littmann® YouTube

50 Heart and Lung Sounds Library


Hear a range of 50 heart and lung sounds

Introduction

The Littmann Library is a quick reference guide for heart and lung sounds. The buttons on the right are used to navigate to sounds associated with each area.

Aortic Area

Click on a sound below to listen to patient recordings and review listening tips. Use the buttons on the right to select another area.

Pulmonic Area

Click on a sound below to listen to patient recordings and review listening tips. Use the buttons on the right to select another area.

Erb's Point

Click on a sound below to listen to patient recordings and review listening tips. Use the buttons on the right to select another area.

Tricuspid Area

Click on a sound below to listen to patient recordings and review listening tips. Use the buttons on the right to select another area.

Mitral Area

Click on a sound below to listen to patient recordings and review listening tips. Use the buttons on the right to select another area.

Lung Sounds

Click on a sound below to listen to patient recordings and review listening tips. Use the buttons on the right to select another area.

Key Features

Each sound has a page where patient recordings can be heard and a phonocardiogram or lung sound waveform can be viewed. We provide half-speed playback of patient cardiac recordings. For many abnormalities, we provide a simulated heart sound as many students find that simulated sounds are a useful learning aid.

System Requirements

Modern browser supporting the .mp3 format (Internet Explorer 9+, Safari, Chrome) is required for audio playback without plugin installation.

For Firefox, Opera and older versions of Internet Explorer, Apple's QuickTime player is used. If your PC does not have QuickTime installed, you may be prompted to install it. During your first visit to our site, your browser may also ask for permission to play the audio recordings.

Please use good quality headphones or earphones. As a test of your headphones, play the 50 Hertz tone (a low frequency humming sound) immediately below. If you can not hear this tone, replace your headphones before using the library.

Aortic Stenosis Moderate and Regurgitation Mild - Rheumatic

Aortic Stenosis - Severe

Aortic Stenosis (Diamond Shaped Systolic Murmur)

Coarctation of the Aorta

First Heart Sound plus Aortic Ejection Click

Prosthetic Heart Sound - Aortic

Atrial Septal Defect

Innocent Murmur

Patent Ductus Arteriosus

Pulmonary Stenosis

Second Heart Sound - Physiologic

Second Heart Sound with Fixed Splitting

Acute Pericarditis

Aortic Regurgitation (Decrescendo Diastolic Murmur)

Mediastinal Crunch

Ebstein's Anomaly

First heart sound (minimally split)

Innocent Systolic Ejection Murmur - Standing

Innocent Systolic Ejection Murmur - Supine

Tricuspid Regurgitation - Severe

Ventricular Septal Defect

Cardiomyopathy - Congestive Moderate

First and second heart sounds - normal & unsplit

Fourth Heart Sound

Mid-Systolic Click

Mitral Regurgitation - Severe

Mitral Stenosis - Moderate

Mitral Valve Leaflet Prolapse

Mitral Valve Prolapse with Mid Systolic Click - Standing

Opening Snap and Second Heart Sound

Prosthetic Heart Sound - Mitral

Second Heart Sound and Late Systolic Click

Summation Gallop at 120 beats per minute

Third and Fourth Heart Sound Gallop

Third Heart Sound - Physiologic

Third Heart Sound - Abnormal

Bronchial

Bronchophony - Abnormal

Bronchophony - Healthy

Bronchovesicular

Crackles - Coarse (Rales)

Crackles - Fine (Rales)

Egophony - a

Egophony - e

Pleural Rubs

Rhonchi - Low Pitched Wheezes

Stridor

Vesicular - Normal

Wheezes - Expiratory

Wheezes - Monophonic

Whispered Pectoriloquy - Abnormal

Whispered Pectoriloquy - Healthy

Aortic Stenosis Moderate and Regurgitation Mild - Rheumatic

Diaphragm Sitting leaning forward

Play Auscultatory Sounds

Listening tips

Systole: Aortic ejection click followed by diamond shaped murmur.
Diastole: High pitch decrescendo murmur.

Aortic Stenosis - Severe

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Systole: Crescendo-decrescendo, harsh, late peaking murmur.
Diastole: S4 gallop.

Aortic Stenosis (Diamond Shaped Systolic Murmur)

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Systole: Diamond shaped, harsh, high pitch, late peaking murmur.

Coarctation of the Aorta

Diaphragm Sitting leaning forward

Play Auscultatory Sounds

Listening tips

Systole: Diamond-shaped murmur, possible early systolic ejection sounds.
S2: Increased intensity.
Diastole: High pitched, decrescendo, early murmur.

First Heart Sound plus Aortic Ejection Click

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Systole: High pitched sound, early in systole, short duration.

Prosthetic Heart Sound - Aortic

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Sounds from a mechanical heart valve with stethoscope at the aortic position.

Atrial Septal Defect

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

Systole: Diamond shaped, brief, early murmur.
S2: Fixed splitting.
Diastole: Diamond shaped, brief, early murmur.

Innocent Murmur

Bell/Diaphragm Supine

Play Auscultatory Sounds

Listening tips

Systole: Early, short duration murmur, increases with inspiration.

Patent Ductus Arteriosus

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

Systole: Crescendo-decrescendo murmur, peaking late systole.
S2: Obscured.
Diastole: Crescendo-decrescendo murmur continuing from systole.

Pulmonary Stenosis

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

S2: Wide splitting.

Second Heart Sound - Physiologic Split

Bell Supine

Play Auscultatory Sounds

Listening tips

S2: Splitting widest at peak inspiration.

Second Heart Sound with Fixed Splitting

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

S2: Fixed splitting throughout respiratory cycle.

Acute Pericarditis

Diaphragm Sitting leaning forward

Play Auscultatory Sounds

Listening tips

S1: Rubbing, scratchy sound.
Systole: Rubbing, scratchy sound, usually loudest during systole.
S2: Rubbing, scratchy sound.
Diastole: Rubbing, scratchy sound.

Aortic Regurgitation (Decrescendo Diastolic Murmur)

Diaphragm Sitting leaning forward

Play Auscultatory Sounds

Listening tips

Diastole: High pitched, musical decrescendo murmur, early diastole.

Mediastinal Crunch

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

Systole: Crunching sound, louder during inspiration.
Auscultate over mitral area and left sternal border.

Ebstein's Anomaly

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

S1: Increased intensity. Possible splitting.
Systole: Rectangular.
S2: Possible splitting..
Diastole: Opening snap followed by decrescendo-crescendo murmur.

First heart sound (Minimally Split)

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

S1: Minimal splitting.

Innocent Systolic Ejection Murmur - Standing

Diaphragm Standing

Play Auscultatory Sounds

Listening tips

Systole: Softer than supine position. Musical not harsh.

Innocent Systolic Ejection Murmur - Supine

Bell/Diaphragm Supine

Play Auscultatory Sounds

Listening tips

Systole: Loud, pan-systolic murmur, louder during inspiration.
Diastole: Brief, rumbling diamond shaped murmur may follow pan-systolic murmur in some cases.

Tricuspid Regurgitation - Severe

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

Diastole: S3 then brief diamond shaped murmur.

Ventricular Septal Defect

Diaphragm Supine

Play Auscultatory Sounds

Cardiomyopathy - Congestive Moderate

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

S1: May be softer.
Systole: Medium pitched, rectangular murmur. Clicks may be heard.
Diastole: S3 present.

First and second heart sounds - normal & unsplit

Diaphragm Supine

Play Auscultatory Sounds

Fourth Heart Sound

Bell Supine

Play Auscultatory Sounds

Listening tips

Diastole: S4 present - a low pitched sound.

Mid-Systolic Click

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

Systole: Listen for a high pitched click.

Mitral Regurgitation - Severe

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

Systole: Rectangular, loud murmur.
S2: Widely split.
Diastole: S3 followed by a diamond shaped, brief murmur.

Mitral Stenosis - Moderate

Bell Supine left side down

Play Auscultatory Sounds

Listening tips

S1: Increased intensity.
Diastole: Opening snap followed by diamond shaped, low pitched murmur.

Mitral Valve Leaflet Prolapse

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

Systole: Click then late systolic diamond shaped murmur.

Mitral Valve Prolapse with Mid Systolic Click - Standing

Diaphragm Standing

Play Auscultatory Sounds

Listening tips

Systole: Click then diamond shaped murmur, louder than supine maneuver.

Opening Snap and Second Heart Sound

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

Diastole: Snap early in diastole, higher pitch than S2.

Prosthetic Heart Sound - Mitral

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Sounds from a mechanical heart valve with stethoscope at the apex.

Second Heart Sound and Late Systolic Click

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

Systole: Higher pitched click late in systole with short duration.

Summation Gallop at 120 beats per minute

Diaphragm Supine

Play Auscultatory Sounds

Listening tips

Diastole: Shortened diastole, S3 & S4 superimprosed.

Third and Fourth Heart Sound Gallop

Bell Supine

Play Auscultatory Sounds

Listening tips

Diastole: S3 and S4 present; galloping sound.

Third Heart Sound - Physiologic

Bell Supine

Play Auscultatory Sounds

Listening tips

S2: Unsplit
Diastole: S3 in early diastole. Low pitch. Galloping (S1,S2,S3) or intermittent sound.

Third Heart Sound - Abnormal

Bell Supine

Play Auscultatory Sounds

Listening tips

S1: Reduced intensity.
S2: Increased intensity.
Diastole: S3 early in diastole, low pitched, heard during expiration.

Bronchial

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Hollow, tubular sounds that are higher pitched. Considered abnormal if heard over the peripheral lung fields. Distinct pause in the sound between inspiration and expiration. Inspiration to expiration ratio of 1:2 or 1:3.

Bronchophony - Abnormal

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Ask patient to say "99" several times. Auscultate chest walls. Over consolidated areas "99" is understandable. For example, pneumonia in the upper lobes, both posterior and anterior. Compare to the Bronchophony - Healthy recording.

Bronchophony - Healthy

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Ask patient to say "99" several times. Auscultate chest walls. Over healthy lung areas "99" is not understandable. Compare this sound to the Bronchophony - Abnormal recording..

Bronchovesicular

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Inspiration to expiration periods are equal.

Crackles - Coarse (Rales)

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Discontinuous, brief, popping sounds. Similar to the sound of a hook and loop fastener being pulled apart. They have also been described as a bubbling sound. More common during inspiration.

Crackles - Fine (Rales)

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Brief, discontinuous, popping sounds that are high-pitched. Similar to wood burning in a fireplace. More commonly heard during inspiration.

Egophony - a

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Ask patient to say "Eeee" several times. Auscultate the chest walls. Over consolidated lung areas, the sound is heard as an "A" (aaay).

Egophony - e

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Ask patient to say "Eeee" several times. Auscultate over chest walls. Over healthy lung areas, the sound is understandable as an "E".

Pleural Rubs

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

These are creaking or grating sounds that have been described as being similar to walking on fresh snow or a leather-on-leather type of sound. Pleural rubs stop when the patient holds a breath.

Rhonchi - Low Pitched Wheezes

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Continuous, low pitched sounds with a gurgling or rattle-like quality. More common during expiration.

Stridor

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

A loud, high-pitched sound wheezing sound heard during inspiration but may also occur throughout the respiratory cycle. Often heard without a stethoscope.

Vesicular - Normal

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Soft and low pitched with a rustling quality during inspiration and even softer during expiration. Inspiration to expiration ratio of 3:1 or 4:1.

Wheezes - Expiratory

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Loud, musical and continuous sounds occuring in expiration. Heard over anterior, posterior and lateral chest walls.

Wheezes - Monophonic

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Loud, continuous sounds occuring throughout the respiratory cycle. Expiration period is frequently longer. Heard over anterior, posterior and lateral chest walls.

Whispered Pectoriloquy - Abnormal

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Ask patient to whisper 1-2-3 several times. Auscultate across chest walls. Abnormal if 1-2-3 sound is understood.

Whispered Pectoriloquy - Healthy

Diaphragm Seated

Play Auscultatory Sounds

Listening tips

Ask patient to whisper 1-2-3 several times. Auscultate chest walls. Over healthly lung areas, '1-2-3' is not intelligible.